Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,570.69 / $2,570.69 / $2,570.69	Facility		$2,570.69	$2,570.69	$2,570.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,968.68 / $2,570.69 / $4,268.32	Professional		$1,968.68	$2,570.69	$4,268.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,095.91 / $5,605.50 / $9,274.56	Facility		$5,095.91	$5,605.50	$9,274.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,407.45 / $4,739.20 / $6,267.96	Professional		$4,407.45	$4,739.20	$6,267.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,665.99 / $10,905.25 / $10,905.25	Facility		$3,665.99	$10,905.25	$10,905.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,001.57 / $11,251.61 / $21,270.57	Facility		$3,001.57	$11,251.61	$21,270.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,191.15 / $7,384.69 / $9,644.40	Professional		$2,191.15	$7,384.69	$9,644.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $2,570.69 / $3,933.16 / $5,860.30	Facility		$2,570.69	$3,933.16	$5,860.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $4,729.35 / $5,095.91 / $6,115.09	Professional		$4,729.35	$5,095.91	$6,115.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,899.65 / $5,095.91 / $21,089.02	Facility		$2,899.65	$5,095.91	$21,089.02
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,344.67 / $3,043.56 / $5,548.81	Professional		$2,344.67	$3,043.56	$5,548.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $3,439.00	Professional		$50.00	$70.00	$3,439.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $2,570.69 / $4,076.73 / $5,860.30	Facility		$2,570.69	$4,076.73	$5,860.30
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $4,729.35 / $5,095.91 / $6,115.09	Professional		$4,729.35	$5,095.91	$6,115.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $5,095.91 / $7,643.87 / $11,850.69	Professional		$5,095.91	$7,643.87	$11,850.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,001.57 / $9,952.94 / $21,089.02	Facility		$3,001.57	$9,952.94	$21,089.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $2,191.15 / $3,001.57 / $26,129.32	Professional		$2,191.15	$3,001.57	$26,129.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,095.91 / $5,095.91 / $5,095.91	Professional		$5,095.91	$5,095.91	$5,095.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $5,095.91 / $5,095.91 / $5,095.91	Professional		$5,095.91	$5,095.91	$5,095.91
United Facility/Professional Professional Modifier Low / Median / High Price $1,694.86 / $2,975.87 / $4,518.10	Professional		$1,694.86	$2,975.87	$4,518.10